Navigation Links
Criteria based on CT imaging after chemotherapy may help predict survival
Date:12/1/2009

Preliminary research suggests that criteria based on computed tomography (CT) imaging of changes in tumors from colorectal liver metastases after chemotherapy with the drug bevacizumab may have the potential to predict overall survival, according to a study in the December 2 issue of JAMA.

The addition of bevacizumab to cytotoxic (toxic to cells) chemotherapy is associated with improved survival in patients with stage IV colorectal cancer and higher pathologic response rates in patients undergoing resection (surgical removal) of colorectal liver metastases. "Recently, pathologic response to preoperative chemotherapy has been shown to correlate with improved survival and has been proposed as a new outcome end point after resection of colorectal liver metastases. To date, a noninvasive method of predicting pathologic response to chemotherapy in colorectal liver metastases, particularly biologic agents, is lacking," the authors write. They add that it has been observed that after bevacizumab-containing therapy, colorectal liver metastases tend not only to decrease in size but also to undergo unique morphologic (form and structure) changes on CT.

Yun Shin Chun, M.D., of the University of Texas M. D. Anderson Cancer Center, Houston, and colleagues conducted a study to validate tumor response criteria that are based on morphologic changes observed on CT in patients with colorectal liver metastases treated with bevacizumab-containing chemotherapy regimens. The researchers analyzed a total of 234 colorectal liver metastases from 50 patients who underwent hepatic resection (removal of tumors involving the liver) after preoperative chemotherapy that included bevacizumab, from 2004 to 2007; date of last follow-up was March 2008. All patients underwent routine contrast-enhanced CT at the start and end of preoperative therapy. Radiologists evaluated images for morphologic response, based on metastases changing from heterogeneous masses with ill-defined margins into homogeneous lesions with sharp borders. These criteria were validated with a separate group of 82 patients with unresectable (unable to be removed by surgery) colorectal liver metastases treated with bevacizumab-containing chemotherapy.

The researchers found that "morphologic criteria correlated strongly with the percentage of residual tumor cells and also with pathologic response stratified as complete, major, or minor using 50 percent residual tumor cells as the cutoff value between major and minor pathologic response. Optimal morphologic response to preoperative therapy translated into a survival benefit after hepatic resection. In a separate validation cohort of patients with unresectable colorectal liver metastases, response by morphologic criteria was also associated with improved overall survival."

The authors add that although the sample size in the surgical group was small, "these results highlight the importance of response rather than baseline clinical factors in determining patient outcome after liver resection."

" our results indicate that morphologic response may be a useful, noninvasive surrogate marker of pathologic response and improved survival in patients with colorectal liver metastases receiving a bevacizumab-containing regimen. It provides complementary information to traditional size-based criteria in assessing CT response to bevacizumab in colorectal liver metastases."


'/>"/>

Contact: Laura Sussman
lsussman@mdanderson.org
713-745-2457
JAMA and Archives Journals
Source:Eurekalert

Related medicine news :

1. Kraft Foods First Company to Adopt Smart Choices Program Nutrition Criteria for Advertising to Children in the U.S.
2. AllMeds' EMR Receives CCHIT 2008 Certification Software Complies with 100 Percent of Certification Criteria
3. HIMSS Electronic Health Record Association Supports Achievable Meaningful Use Criteria in Comments to ONC
4. Blue Cross/Blue Shield Of Massachusetts Introduces Controversial Criteria For Vein Treatment Reimbursement
5. HIMSS Electronic Health Record Association Executives Testify at NCVHS Hearings on Meaningful Use Criteria
6. Together Rx Access(R) Program Expands Eligibility Criteria, Responds to Challenging Economic Times
7. New criteria for measuring tumor size and progression will help ease workloads in clinical trials
8. New appropriate use criteria guide treatment of patients with heart blockage
9. Eligibility criteria contribute to racial disparities in hospice use
10. New Criteria Could Expand Number of Liver Transplant Candidates
11. How Patients Can Meet the Criteria for Insulin Pump Therapy
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/20/2017)... ... February 20, 2017 , ... Scrubbing in for his first ... Dr. Christopher Pezzi remembers the excitement of the surgeon training him. , “He was ... to do this? Don’t tell anyone, but I would do it for free,’” Dr. ...
(Date:2/20/2017)... ... 2017 , ... Today, Biscom , the leader in ... IoT device from Biscom designed to deliver confidential patient information securely and quickly, ... HIMSS17 and will be conducting demonstrations at Booth #374. , With ...
(Date:2/20/2017)... , ... February 20, 2017 , ... Johns Hopkins All ... education building. A topping out ceremony on Friday marked the halfway point of construction ... to open in Fall 2018, will serve as a center for innovation aimed at ...
(Date:2/19/2017)... (PRWEB) , ... February 19, 2017 , ... Braun Industries ... JEMS Conference & Exposition, the event will take place February 23-25, 2017 at the ... will be in Booth #909 with three new ambulances on display. ...
(Date:2/18/2017)... ... February 17, 2017 , ... Focused start-ups, not traditional health ... according to the recent NEJM Catalyst Insights Report on the New Marketplace. ... Insights Council, a qualified group of U.S. executives, clinical leaders, and clinicians at ...
Breaking Medicine News(10 mins):
(Date:2/20/2017)... ORLANDO, Fla. , Feb. 20, 2017 /PRNewswire/ ... are helping physicians diagnose and treat patients with ... will provide wireless connectivity for ZywiePro, Zywie,s cardiac ... AT&T Control Center . AT&T ... accessible monitoring for those with the disease. The ...
(Date:2/20/2017)... , Feb 20, 2017 Research and ... Devices Global Market -Forecast to 2022" report to their ... ... rise in aging population, rising adoption of tension free repair ... the growth of hernia repair devices global market. However, Inconsistent ...
(Date:2/20/2017)... 2017 The global  animal ... billion by 2025, according to a new study ... driven by technological advancements in veterinary care, which ... the market. For instance, MediLabSecure, a laboratory network ... emerging viruses and pathogens in 19 countries in ...
Breaking Medicine Technology: